内镜黏膜下剥离术治疗消化道黏膜下肿瘤的疗效分析

The efficacy analysis of endoscopic submucosal dissection for gastrointestinal submucosal tumors

目的探讨内镜黏膜下剥离术(ESD)治疗消化道黏膜下肿瘤(submucosal tumor,SMT)的疗效及安全性。方法选取我院2008年3月-2011年6月经胃肠镜检查发现消化道黏膜下肿瘤48例,回顾性分析48例患者资料,包括患者的基本情况、病变部位、大小、治疗经过以及病理结果等,统计并发症发生情况及术后随访结果。结果病灶直径为0.8～5.8 cm,平均(3.3±0.75)cm,ESD手术时间为27～167 min,平均(71.0±22.6)min,ESD完整切除病灶45例(45/48,93.75%),穿孔3例(3/48,6.25%),其中1例大出血,1例食管患者ESD术后出现食管狭窄,经内镜下球囊扩张食管狭窄消失。所有病人均完成了术后6个月的内镜随访,1例患者见肿瘤复发。结论 ESD技术对较大病变可以整块切除,并提供完整的病理诊断资料;消化道SMT行ESD术是安全、有效的。

Objective To investigate the efficacy and safety of endoscopic submucosal dissection for gastrointestinal submucosal tumors.Methods Data of 48 patients with gastrointestinal submucosaltumors,who underwent ESD,were reviewed in terms of personal situation,location and size of lesions,managements,pathology,complications and follow-up findings.Results The lesion size ranged from 0.8 to 5.8 cm[mean（3.3±0.75）cm]and the operation time was 27~167 min[mean（71.0±22.6） min）],the ESD resection rate was 93.75%,the perforation rate was 6.25%.One patient had massive hemorrhage during ESD,one esophageal stenosis happened after ESD for esophageal lesion,and then was treated under endoscopic balloon dilation.There were 48 cases with six months follow-up by gastroscopy,one recurrence was found.Conclusion ESD is an efficacious and safe procedure for the treatment of SMT,it is possible to completely exsect suhmueosal lesions and provide sufficient pathological information.